# ANDRE ELIASIAN DENTAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508281387
- **Authorized official:** DR. ANDRE ELIASIAN DDS (OWNER/DENTIST)
- **Authorized official phone:** (818) 632-5005

## Contact information

- **Practice address:** 1224 STANLEY AVE UNIT 10, GLENDALE, CA 91206-5629
- **Practice address phone:** (818) 632-5005
- **Mailing address:** 290 E VERDUGO AVE, 208, BURBANK, CA 91502-1300
- **Mailing address phone:** (818) 861-7427
- **Mailing address fax:** (818) 861-7426

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 62927 | CA | Yes |

## Other

- **Enumeration date:** 03/03/2014
- **Last updated:** 03/03/2014